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. 2025 Apr;31(4):e70358.
doi: 10.1111/cns.70358.

Impact of Anesthesia on Brain Functional Networks in Moyamoya Disease and Spinal Lesions

Xuanling Chen  1   2 , Xuewei Qin  2 , Zhengqian Li  1 , Shengpei Wang  3 , Zhenhu Liang  4 , Hua Zhang  5 , Lan Yao  2 , Xiaoli Li  6 , Ran Duan  7 , Rong Wang  8 , Xiangyang Guo  1
Affiliations

Impact of Anesthesia on Brain Functional Networks in Moyamoya Disease and Spinal Lesions

Xuanling Chen et al. CNS Neurosci Ther. 2025 Apr.

Abstract

Aims: To analyze the effects of intravenous propofol combined with remifentanil on whole-brain functional networks in patients with ischemic moyamoya disease (IMMD) and intraspinal space-occupying lesions (SOLs) using resting-state functional magnetic resonance imaging (rs-fMRI).

Methods: Ten patients with IMMD and 10 sex- and age-matched patients with lumbar SOL (normal cerebrovascular findings on preoperative MRI) were recruited. General anesthesia was administered using propofol and remifentanil. rs-fMRI imaging was performed in both awake and anesthetized states. Whole-brain functional network in different states was constructed based on graph theory tools.

Results: In awake patients with IMMD, significant reductions in nodal strength (NS) were observed in the default mode network (DMN), sensorimotor network, and frontoparietal control network (FPN), compared to patients with SOL. Nodal efficiency (NE) showed further significant network declines. Under anesthesia, patients with IMMD: (1) exhibited disease-specific decreases in NS and NE across several networks, potentially reflecting underlying cerebral pathology. (2) Propofol's effects also contributed to significant NS and NE reductions in several brain regions. Changes before and after anesthesia in patients with IMMD were significantly decreased in specific regions (discussed in detail) per analysis of NS versus NE. DMN connectivity correlated moderately with Montreal Cognitive Assessment scores.

Conclusions: Reduced whole-brain functional connectivity in patients with IMMD before anesthesia was similar to the alterations caused by systemic intravenous drugs administered after anesthesia.

Trial registration: ChiCTR2300075268.

Keywords: brain network; intraspinal space‐occupying lesions; ischemic Moyamoya disease; propofol; resting‐state functional magnetic resonance.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) NS analysis of IMMD in the awake state; (B) NE analysis of IMMD in the awake state (blue dots represent brain areas with a significant decrease in change). AC, anterior cingulate cortex; MFG, middle frontal gyrus; PCC, posterior cingulate cortex; SMA, supplementary motor area.
FIGURE 2
FIGURE 2
(A, B) Analyses of the topological properties of the brain complex nodes of IMMD under anesthesia; (A) Analysis under NS; (B) Analysis under NE (yellow dots represent difference before anesthesia, no difference after anesthesia; blue dots represent no difference before anesthesia, difference after anesthesia; red dots represent difference both before and after anesthesia). ACC, anterior cingulate cortex; MFG, middle frontal gyrus; MTG, middle temporal gyrus; PCC, posterior cingulate cortex.
FIGURE 3
FIGURE 3
(A, B) Analyses of topological properties of brain complex nodes in IMMD before and after anesthesia; (A) Analysis under NS; (B) Analysis under NE (blue dots represent brain areas with a significant decrease in changes). MFG, middle frontal gyrus; MTG, middle temporal gyrus; PCC, posterior cingulate cortex; SMA, supplementary motor area.
FIGURE 4
FIGURE 4
Correlation between DMN and MoCA scores at admission and discharge.
See this image and copyright information in PMC

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